Deep Face, 23 Sept 2006

Courtney Takahashi Anatomy 4 – Deep Face 23 September 2006 Identify the following skeletal elements: • Mandible • Temporal fossa (p. 979 of Moores) • Infratemporal fossa (p. 979 of Moores) • TMJ • Pterygomaxillary fissure (plate 4 of netters) • Pterygopalatine fossa (small pyramidal space inferior to apex of the orbit) (plate 4) Grants: o Superior and inferior temporal lines o Zygomatic arch o Mandibular fossa and articular tubercle Within the temporal mandibular joint: • Condyle of the mandible (palpable, just anterior to the tragus) (plate 13) • Mandibular fossa (plate 14) • Articular disc (plate 14) • Stylomandibular ligament (plate 14) Grants: o Lingular o Mandibular foramen o Mylohyoid groove o Pterygomaxillary fissure o Inferior orbital fissure o Infratemporal surface of maxilla o Greater wing of sphenoid bone o Lateral plate of pterygoid process o Pterygopalatine fossa o Sphenopalatine foramen Maxillary Artery • Mandibular o Deep auricular o Deep temporal o Anterior tympanic o Middle meningeal o Accessory meningeal o Inferior alveolar • Pterygoid

•

o Masseteric artery o Temporals o Pterygoid o Buccal Pterygopalatine o Posterior superior alveolar o Infraorbital artery with branches to maxillary teeth o Descending palatine with greater and lesser palatine branches o Artery to pterygoid canal o Sphenopalatine artery, arteries to nasal cavity

Maxillary Vein, terminates when it joins with temporal vein and forms retromandibular vein Trigeminal Nerve (CN V) Maxillary Division (V2) o Infraorbital nerve o Posterior superior alveolar nerve o Middle superior alveolar nerve o Anterior superior alveolar nerve o Palatine nerve o Zygomaticofacial and zygomaticotemporal nerve o Nasopalatine nerve Mandibular division o Buccal nerve o Auriculotemporal o Lingual*, find, and provides general sensation to anterior 2/3 of tongue o Inferior alveolar nerve, mental nerve Muscles of Mastication (what is their innervation?) • Temporalis muscle o Blood supply? Maxillary and superficial temporal arteries o Functions? Elevate mandible, retract mandible • Masseter o Attachments? Zygomatic to ramus angle of mandible o Blood supply? Masseteric branch of maxillary artery o Function? Elevates mandible and occludes teeth during mastication • Medial pterygoid o Attachments? Medial surface of lateral pterygoid plate and internal angle of mandible o Blood supply? Pterygoid branch of maxillary artery o Functions? Elevates mandible, grinding, protrude mandible • Lateral pterygoid o Attachments? Zygomatic to angle of mandibular ramus o Blood supply? Masseteric branch of maxillary artery

•

o Function? Digastrics? o Attachments? o Blood? o Function? o Nerve?

How could a person dislocate the TMJ? What are signs of arthritis TMJ? What are the communications of the pterygopalatine fossa?

What are the contents of the pterygopalatine fossa?

Protrude jaw, swings mandible to contralateral side during chewing Post. belly  mastoid, ant  digastric fossa of mandible, both to hyoid Post  post auricular, occipital; Ant.  submental branch of facial Depress mandible and stabilize hyoid Post.  VII, Ant.  V3 1st 15° condylar head rotation, but beyond 15°, the condyle translates laterally. Thus, if a person had a shallow mandibular opening, the jaw can become displaced. Malocclusion and crepitus Lateral – Pterygomaxillary fissure  infratemporal fossa Medial – Nasal cavity  sphenopalatine foramen Anterosuperiorly – Inferior orbital fissure  orbit Posterosuperiorly – f. rotundum and pterygoid canal  middle cranial fossa Pterygopalatine portion of maxillary artery with branches Maxillary nerve components, including: • Pterygopalatine ganglion • Descending palatine nerve • Infraorbital branch of V2 • Nerve to pterygoid canal